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Mivelsiran (ALN-APP) is an investigational RNA interference (RNAi) therapeutic designed to target and silence amyloid precursor protein (APP) messenger RNA in the central nervous system. By reducing APP mRNA, mivelsiran decreases synthesis of APP protein and all downstream cleavage products, including amyloid beta (Aβ), which are implicated in the pathogenesis of Alzheimer’s disease (AD) and cerebral amyloid angiopathy (CAA). The drug is administered intrathecally and utilizes Alnylam’s proprietary C16-siRNA conjugate technology for enhanced CNS delivery. Mivelsiran aims to reduce both intracellular and extracellular Aβ isoforms as well as other APP-derived peptides by acting upstream at the level of gene expression. It is currently being evaluated in clinical trials for CAA (Phase 2) and early-onset AD (Phase 1)[1][3][5][8].
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